Summary of Qualifications:
– Possess over 20 years experience in the Medical Billing and Insurance fields.
– Possess over 30 years experience in the Credit and Collections field.
– Exceptional work ethic; consistent, reliable, hard working, self-motivated, disciplined, and able to work well in a team environment or independently.
– Capable of leading and motivating staff, yet willing to take direction.
– Computer literate: Windows XP, Windows 10, Microsoft Word, Microsoft Excel, Microsoft PowerPoint, Internet, and email knowledge; capable of rapidly learning company-specific software.
Experience
TMG Health/Cognizant, Jessup PA
Claims Process Executive/Subject Matter Expert – 08/2013-Present
– Facility claims processing; Cross-trained in Medicare, Medicaid, Skilled Nursing, End-Stage Renal, Home Health
– Review and research customer service inquiries, appeals and check tracers
– Special claims projects
– Quality control for trainees
– Medicare and Medicaid specialist
– Assist with claims issues
– Reprocessing of claims, reissuing checks
Community Medical Center, Missoula, MT
Physician Billing Representative, 10/2012-08/2013
– Handled all communication involving accounts receivable
– Reconciliation of patient and insurance company concerns
– Timely and accurate billing of professional and facility claims
– First line of contact for both patients and insurance companies
– Daily collection of receipts from physician practices
– Responded to correspondence from insurance companies and patients
– Identified and resolved patient billing and payment issues
– Confidently and adeptly handled claim denials and appeals
– Reviewed monthly patient and insurance aging reports and solicited overdue payments

DirectTV, Missoula, MT
Customer Service Representative, 04/2012-10/2012
– Navigated through multiple data entry systems and other resources while speaking with customers
– Resolved customer questions and issues in a professional and courteous manner
– Met and exceeded established call center productivity and quality standards
– Positioned products for services appropriately after assessing customer needs

Comcast Business Class, Horsham, PA
Retention Specialist, 02/2011-07/2011
– Responsible for revenue retention of commercial accounts
– Minimized account disconnections by managing the resolution of technical trouble calls, billing issues, outages and customer dissatisfaction with product and process
– Strategically offered product bundles and price points that met the needs of the customer’s budget and business application
– Met and exceeded budgeted retention goals for all product lines

Reimbursement Technologies Inc, Conshohocken, PA
Correspondence Trainer/Supervisor, 08/1998-11/2010
– Responsible for the training and supervision of new employees for the Correspondence and Hospitalist departments
– Trained new employees on departmental procedures, computer programs, customer service, and collections as well as coordinating and presenting informational training sessions for existing employees
– Kronos payroll
– Participated in the Management Training program
– Applied Corrective Action when necessary
Advanced Denial A/R Representative
– Responsible for researching and resolving insurance denials
– Identified, reviewed and resolved problem accounts
– Composed letters of appeal to insurance companies
– Assisted with incoming insurance and patient calls
– Contacted insurance companies to obtain payment and denial information
Education
Montgomery County Community College, Blue Bell, PA, in progress
References Upon Request